title: Efficacy of low-dose methotrexate treatment in birdshot chorioretinopathy.
abstract: OBJECTIVE
  To ascertain the effect of treatment with methotrexate (MTX) on the visual prognosis of birdshot chorioretinopathy (BSCR).
  
  
  METHODS
  Retrospective case series of 76 consecutive patients with HLA-A29-positive BSCR, of whom 46 were followed for at least 5 years and 18 for longer than 10 years. A review of the medical records of 76 patients with BSCR. Treatment regimens were subdivided into the following groups: 1) No systemic immunomodulatory treatment; 2) Treatment with systemic corticosteroids; and 3) Treatments which comprised MTX. First, we calculated eye-years for the different therapeutic regimens and second, we subdivided the patients according to their initial treatment regimen and assessed visual outcomes.
  
  
  RESULTS
  Mean visual acuity increased over time in the MTX-treated patients; remained unchanged in patients on systemic corticosteroids and decreased in the patients without systemic treatment (yearly change in LogMar -0.020, -0.034 and 0.028 with P = 0.034, P = 0.71 and P = 0.006 respectively). In the group treated initially with MTX, VA gradually increased in contrast to the remaining groups of patients (P = 0.003).
  
  
  CONCLUSIONS
  In this series, treatment comprising MTX showed better visual outcomes than the untreated patients and corticosteroid-based treatment regimens.
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands. a.rothova@umcutrecht.nl
authors.forename: Aniki
authors.initials: A
authors.lastname: Rothova
authors.forename: Annette
authors.initials: A
authors.lastname: Ossewaarde-van Norel
authors.forename: Leonoor I
authors.initials: LI
authors.lastname: Los
authors.forename: Tos T J M
authors.initials: TT
authors.lastname: Berendschot
mesh_terms: D002825:Chorioretinitis / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D015234:HLA-A Antigens / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005938:Glucocorticoids; D015234:HLA-A Antigens; C035524:HLA-A29 antigen; D007166:Immunosuppressive Agents; D008727:Methotrexate